Osteoporosis

Question 1

The skeleton is metabolically active. T or F?

Answer 1

true

Question 2

Remodeling is necessary to maintain the structural ________ of the skeleton and to serve a metabolic function as a storehouse of __________and _________ for many functions

Answer 2

integrity; calcium and phosphorus

Question 3

Bone mass peaks between _________ yrs.
-Why is this important?

Answer 3

25-35 yrs.
essentially you want to set your peak high before you reach the range

Question 4

persistent metabolic disease is what condition?

Answer 4

osteoporosis

Question 5

Osteoporosis is characterized by the following: (4)

Answer 5

low bone mass
impaired bone quality
decreased bone strength
enhanced risk of fractures

Question 6

What is the primary/MOST common association of osteoporosis?

Answer 6

age-related changes, hormone and calcium levels and physical activity

Question 7

What is the secondary etiology of osteoporosis?

Answer 7

consequence of disease (parathyroid) or medication

Question 8

osteoporosis is ______% undiagnosed
MOST common _______ disease

Answer 8

70%
metabolic

Question 9

What is osteopenia or low bone mass

Answer 9

precursor to osteoporosis

Question 10

Osteoporosis risk factors:
-lower ________ levels such as _________ (females) and _______ (males)
-limits bone ______________

Answer 10

hormone; estrogen; testosterone
resorption

Question 11

Osteoporosis can be genetically inherited? T or F

Answer 11

True

Question 12

how much caffeine per day is recommended to limit osteoporosis from occurring?

Answer 12

< 3 cups (8 oz. in a cup) of caffience per day

Question 13

What is a standard question to ask women (65≥) and males (≥70) yrs.

Answer 13

Dexa Scan

Question 14

Pathogenesis of Osteoporosis:

-primarily a metabolic disorder as _____________ activity > ___________ activity

-secondarily an ____________disorder due to other conditions that limit calcium, estrogen, and testosterone

Answer 14

osteoclastic > osteoblastic
endocrine

Question 15

Pathogenesis of Osteoporosis:

_________,__________, and _________ of vertebral body MOST often in lower thoracic and upper lumbar regions

Answer 15

wedging, compression, and fx

Question 16

What are 3 common areas of fx
note - non traumatic > traumatic

Answer 16

femurs, ribs, radius

Question 17

Osteoporosis is often symptomatic before fx occurs. T or F

Answer 17

false; asymptomatic

Question 18

Observation/Risk Factors of Osteoporosis: (3)

Answer 18

FHP
Loss of height
Increased thoracic and lumbar kyphosis- fulcrums (even @ rest) or rounded slouched posture

Question 19

Fx often occurs with a seemingly benign _______ activity
ex:

Answer 19

flexion
-bending; sneezing

Question 20

Why would P! refer to flanks and abdominal region?

Answer 20

shared innervations

Question 21

Osteoporosis S&S:
Fx S&S plus severe _________ P! between _______ and _________ spinal regions especially with ________,______ and __________stresses

Answer 21

back; mid thoracic and lumbar
flexion, compression, and valsalva

Question 22

What would be expected scan findings for Osteoporosis:
ROM:
Resisted Tests:
Stress Test:
Neuro:

Answer 22

ROM: P! and limited primarily w/ flexion but possibly all directions

Resisted Tests: P! and weakness, primarily w/ flexion but possibly all directions

Stress: P! w/ compression likely relief with distx
P! w/ PA pressures

Neuro: MOST often negative

Question 23

Osteoporosis Biomechanical Exam: Special Tests (2)

Answer 23

Percussion
Supine Sign (inability to lie flat due to P!)

Question 24

Osteoporosis:
-If suspected Fx most likely _________referral
-If suspected neurological symptoms or inability to walk ________referral

Answer 24

urgent
emergency

Question 25

PT Rx: Osteoporsois

-Even if an fx, it is usually ________ and able to tolerate Rx due to _________ so proceeded based on symptoms

-Positional and directional preference w/ education treatments, and activities – give examples

Answer 25

stable; ligamentous structure

directional preference: EXT
pt. edu: slip-on shoes, corset
bracing; assistive devices (cane/reacher)

Question 26

PT Rx: MET focuses on osteoporosis
MT:

Answer 26

bone integrity (maintenance or improving density
balance
walking and resistance training

JM: be cautious with JM’s, particularly high grades if advanced level of disease or ≥ 3 mths of corticosteroid use

may utilize JM to normalize motions and stresses throughout the spine

Question 27

The majority will heal after _____ to______ weeks of conservative treatment with a subsequent decline in P!

Answer 27

8-12 weeks

Question 28

MD RX:
————- ————-:
good treatment for pts. with ______/______ P!

Answer 28

Percutaneous vertebroplasty
acute/subacute

*basically biological cement

Question 29

what is osteomalacia?

Answer 29

bone softening without loss of bone mass or brittleness as with osteoporosis

Question 30

osteomalacia Etiologic Factors:

Answer 30

insufficient intestinal calcium absorption due to lack of calcium or more likely low vit D.

Increased kidney phosphate loss

Question 31

osteomalacia Risk Factors:

Answer 31

lack of dietary or sunlight Vit. D
Malabsorption conditions including age affect digestive and metabolic functions
Medications alter Vit. D, calcium, or phosphate

Question 32

osteomalacia pathogenesis:
lack of ______ salts
structure _______ but still weakness in the bone w/possible fx
primarily affects _____ and _______

Answer 32

calcium
unchanged
vertebra and femur

Question 33

osteomalacia S&S:
________and often ______ due to diffuse achiness and fatigue w, wt. loss
LBP and pelvic and LE P!, aggravated by __________
muscles _______ and polyneuropathy

Answer 33

difficult;delayed
weight bearing
weakness

Question 34

osteomalacia had greater neuromuscular influences than osteoporosis. T or F

Answer 34

True